Provider Demographics
NPI:1396580148
Name:MONROE, HOLLEY BRIDGES
Entity type:Individual
Prefix:
First Name:HOLLEY
Middle Name:BRIDGES
Last Name:MONROE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 COUNTRY DAY DR
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-9460
Mailing Address - Country:US
Mailing Address - Phone:919-815-8595
Mailing Address - Fax:
Practice Address - Street 1:7048 KNIGHTDALE BLVD STE 220C
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-8894
Practice Address - Country:US
Practice Address - Phone:919-944-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0208511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical